Allergy Testing and Immunotherapy

If your child has year-round allergies or severe symptoms, the standard allergy medications may not be enough. Here's what else you can do to help your little one feel better.

You’ve been through the routine: You forbid shoes beyond your front door, vigilantly wash your cutie’s clothes after she’s been outside, and regularly vacuum with a HEPA filter — plus, you’ve tested every safe allergy med under the sun — but she’s still incessantly sniffling and sneezing. What gives? When oral drugs or nasal sprays fail to alleviate your tot’s seasonal-allergy symptoms or her symptoms occur year-round, an allergist may suggest immunotherapy, otherwise known as allergy shots. If you decide to go this route, here’s what to expect.

Allergy Testing

There are two common ways allergists test kids to zero in on the offending allergen(s):

Skin-Prick Test. This is the most common allergy test, in which an allergist will prick tiny amounts of various allergens into the skin (usually the upper arm or back) to see which types cause a reaction (a raised bump at the test location indicates an allergic reaction).

Allergy Blood Test. Another way to measure the immune system’s response to a specific allergen is the radioallergosorbent (RAST) test, a blood test that counts the immunoglobulin E (IgE) antibodies in your child’s bloodstream (high counts point to an allergy).

Immunotherapy

Following a positive allergy test, the allergist will make sure that your child’s symptoms cannot be relieved by more standard treatments like antihistamines, decongestants, and nasal sprays. The doctor may then recommend allergen immunotherapy, a series of allergy shots given over a period of three-to-five years. Immunotherapy is usually effective in reducing allergy symptoms, can help prevent the development of new allergies, and, in children, can prevent the progression of allergic rhinitis (allergic inflammation of the nasal airways) into asthma. That’s important, since allergies have been shown to precede asthma and nearly four in ten people who suffer from allergic rhinitis also develop asthma.

Immunotherapy works similarly to a vaccine, helping your child build immunity (or develop a tolerance) to a specific allergen by gradually increasing the dose of that allergen with each injection, ultimately minimizing symptoms. Like vaccines, risks include redness and swelling at the injection site. Though rare, serious risks like anaphylaxis (an allergic reaction in which blood pressure drops and airways narrow, restricting the breath) can occur — so shots are almost always given at the doctor’s office to watch for (and, when necessary, treat) such a reaction.

Immunotherapy is not typically recommended for children younger than five, mainly because of the difficulties of administering shots to kids that young.

Time available for treatment (in the beginning, shots are given once or twice a week. After about three to six months, your child will follow a maintenance schedule of monthly shots for three to five years)

Costs, which vary depending on your insurance coverage and the region where you live

Be aware, too, that while many people see lasting relief once they’ve completed a full cycle of immunotherapy, some need to continue treatment to get long-term results.